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Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options

Optic disc pit (ODP) is a rare congenital anomaly of the optic disc, which can be complicated by a maculopathy associated with progressive visual loss. Optic disc pits are usually unilateral and sporadic in occurrence, and the development of maculopathy is unpredictable with no known triggers. Optic...

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Autores principales: Moisseiev, Elad, Moisseiev, Joseph, Loewenstein, Anat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088488/
https://www.ncbi.nlm.nih.gov/pubmed/27847606
http://dx.doi.org/10.1186/s40942-015-0013-8
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author Moisseiev, Elad
Moisseiev, Joseph
Loewenstein, Anat
author_facet Moisseiev, Elad
Moisseiev, Joseph
Loewenstein, Anat
author_sort Moisseiev, Elad
collection PubMed
description Optic disc pit (ODP) is a rare congenital anomaly of the optic disc, which can be complicated by a maculopathy associated with progressive visual loss. Optic disc pits are usually unilateral and sporadic in occurrence, and the development of maculopathy is unpredictable with no known triggers. Optic disc pit maculopathy (ODP-M) is characterized by intraretinal and subretinal fluid at the macula, causing visual deterioration. The source of this fluid is still unclear, and several competing theories have suggested it may be vitreous fluid, cerebrospinal fluid, leakage from blood vessels at the base of the pit or leakage from the choroid. The mechanism of pathogenesis of ODP-M has not been fully elucidated, but vitreous liquefaction and traction and pressure gradients within the eye have been implicated to be involved. There are no clear guidelines on the management of patients with ODP-M, and numerous techniques have been described, including laser photocoagulation, intravitreal gas injection, macular buckling and pars plana vitrectomy with many different modifications. The majority of reports describe small series, and as there are no comparative studies there is no consensus regarding the optimal treatment for ODP-M. This review discusses the literature on the possible sources of fluid and mechanisms of pathogenesis in ODP-M, as well as the wide array of treatment modalities and their results. Based on these, a set of recommended key concepts for the timing and choice of treatment for these challenging are presented.
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spelling pubmed-50884882016-11-15 Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options Moisseiev, Elad Moisseiev, Joseph Loewenstein, Anat Int J Retina Vitreous Review Optic disc pit (ODP) is a rare congenital anomaly of the optic disc, which can be complicated by a maculopathy associated with progressive visual loss. Optic disc pits are usually unilateral and sporadic in occurrence, and the development of maculopathy is unpredictable with no known triggers. Optic disc pit maculopathy (ODP-M) is characterized by intraretinal and subretinal fluid at the macula, causing visual deterioration. The source of this fluid is still unclear, and several competing theories have suggested it may be vitreous fluid, cerebrospinal fluid, leakage from blood vessels at the base of the pit or leakage from the choroid. The mechanism of pathogenesis of ODP-M has not been fully elucidated, but vitreous liquefaction and traction and pressure gradients within the eye have been implicated to be involved. There are no clear guidelines on the management of patients with ODP-M, and numerous techniques have been described, including laser photocoagulation, intravitreal gas injection, macular buckling and pars plana vitrectomy with many different modifications. The majority of reports describe small series, and as there are no comparative studies there is no consensus regarding the optimal treatment for ODP-M. This review discusses the literature on the possible sources of fluid and mechanisms of pathogenesis in ODP-M, as well as the wide array of treatment modalities and their results. Based on these, a set of recommended key concepts for the timing and choice of treatment for these challenging are presented. BioMed Central 2015-08-07 /pmc/articles/PMC5088488/ /pubmed/27847606 http://dx.doi.org/10.1186/s40942-015-0013-8 Text en © Moisseiev et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Moisseiev, Elad
Moisseiev, Joseph
Loewenstein, Anat
Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options
title Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options
title_full Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options
title_fullStr Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options
title_full_unstemmed Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options
title_short Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options
title_sort optic disc pit maculopathy: when and how to treat? a review of the pathogenesis and treatment options
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088488/
https://www.ncbi.nlm.nih.gov/pubmed/27847606
http://dx.doi.org/10.1186/s40942-015-0013-8
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